Current topics in liver surgery

Abstract

Liver resection is one of the main treatment strategies for liver malignancies. Mortality and morbidity of liver surgery has improved significantly with progress in selection criteria, development of operative procedures and improvements in perioperative management. Safe liver resection has thus become more available worldwide. We have identified four current topics related to liver resection (anatomical liver resection, laparoscopic liver resection, staged liver resection and chemotherapy‐induced liver injury). The balance between treatment effect and patient safety needs to be considered when planning liver resection. Progress in this area has been rapid thanks to the efforts of many surgeons, and outcomes have improved significantly as a result. These topics remain to be solved and more robust evidence is needed. Precise selection of the optimal procedure and risk evaluation should be standardized with further development of each topic. The present article reviews these four current topics with a focus on safety and efficacy in recent series.

Risk factors for blood loss in liver resection surgery: An Institutional Review.

“…In our study, the use of preoperative chemotherapy has not been associated with increased blood loss during liver resection compared to the patients who underwent upfront surgeries. These results, compared with international studies, showed a similar outcome 10 .…”

Subcuticular sutures reduce surgical site infection after repeat liver resection: a matched cohort analysis

“…These results support minimally invasive hepatobiliary surgeries such as laparoscopic liver resection as one possible option to reduce wound complication rates. Indeed, the rate of severe complications was similar between open and laparoscopic surgeries, while the total wound complication rate was lower and operation time was shorter with laparoscopic surgery than with open surgery (18)(19)(20). Laparoscopic surgery is thus one feasible option when the tumour extension is preferable for laparoscopic surgery.…”

Is Aryl Hydrocarbon Receptor Antagonism After Ischemia Effective in Alleviating Hepatic Ischemia-Reperfusion Injury in Rats?

“…Hepatic ischemia-reperfusion (IR) injury commonly occurs during liver transplantation or resection and is considered a leading cause of liver damage and dysfunction. [1][2][3][4][5] The mechanisms of hepatic IR injury have been extensively investigated, but nevertheless remain largely unclear. Furthermore, although anaerobic metabolism, mitochondria, oxidative stress, intracellular calcium overload, liver Kupffer cells (KC), neutrophils, cytokines, and chemokines have been found to be involved in the hepatic IR injury process, effective prevention or treatment in clinical practice is still lacking.…”